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Checks should be made out to MiBAP. Please return a copy of this entire completed Membership Application with your check to:

Michigan Behavior Analysis Providers (MiBAP)
1100 S Rose St
Kalamazoo MI 49001-2664

Questions? Contact Us at membership@MiBAP.org

MIBAP Membership Application 2021

PROFESSIONAL INFORMATION

Facility Address(Required)
Primary Contact Name(Required)
Secondary Contact Name

MEMBERSHIP CATEGORY

MiBAP membership dues are determined based on annual ABA services revenue in the state of Michigan. Dues cover membership for a one-year period.
Select a Membership Tier(Required)

MEMBERSHIP AGREEMENT

Please Read and Agree(Required)
Name of Person Consenting to the Membership Agreement